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Individual
WENDY KAY KELLAM
Active
Individual
WENDY KAY KELLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
—
NULL
363A00000X
Physician Assistant
Primary
PA60638000
WA
363AM0700X
Medical Physician Assistant
PA164630
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083892665
—
WA
05
—
500663009
—
OR
Enumeration date
02/05/2008
Last updated
10/14/2020
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